Tuesday, July 26, 2011

Antibiotics and Celiac Disease : Any Connection?

Do Antibiotics Make Celiac Disease More Likely?


Antibiotics Disrupt Gut Ecology, Metabolism

Today's Gluten-Free Blog entry was inspired as I was reading an interesting article that discussed the findings published in materials originally provided by the American Society for Microbiology, whereby researchers from Canada described many of the interactions between the intestinal microbiota and host [in their testing, the "hosts" were mice], and showed that antibiotics profoundly disrupt intestinal homeostasis (i.e., equilibrium as maintained by physiological processes). So, what happens when your intestinal equilibrium is potentially compromised by antibiotics?

Could there be a connection to gluten-intolerance and/or Celiac disease? Some portions of their findings sure made me wonder. Given how massive shifts were observed in the levels of things like hormones that affect our immune system, sugar metabolism, and more, I could not help thinking that there could be a connection with gluten-sensitivity and/or Celiac Disease.

I have also heard the term "leaky gut syndrome" thrown around by some people (though not a "recognized diagnosis", it is a hypothesis that your gut wall suffers increased permeability from exposure to toxins, infections, and medications like antibiotics). This term has been used alongside Celiac Disease and/or gluten-intolerance, autism, and chronic fatigue syndrome to name a few. Whether it is a really the cause of any of these conditions is unknown, but the theory (in relation to celiac / gluten-intolerance) is that while your intestine is in a state of increased permeability, gluten proteins (e.g., Gliadin glycoprotein) can cross into the blood where the proteins would be targeted by antibodies, and thus eventually induce an allergic/immune-response to gluten as a result of stimulating the release of cytokines (I will come back to the cytokine thing later in this blog).

Why Intestinal Microbes are Important

Normal, healthy humans each carry around several pounds of microbes in their gastro-intestinal tracts. As gross as this may sound, we need these beneficial microbes. As stated in the article (on Science Daily):
"Intestinal microbes help us digest our food, provide us with vitamins that we cannot make on our own, and protect us from microbes that make us sick, amongst other things,"
So, how profoundly do antibiotics interact with these necessary and beneficial microbes?

Antibiotics Caused Huge Changes, Including Hormone Shifts

Researchers examined over 2000 molecules present in mouse excrement before and after (administration of antibiotics to the mice) to see what changes were observable and induced by antibiotics. The "after" (antibiotics) exam showed some really amazing (perhaps scary) results where:
The second round of mass spectroscopy revealed a very different metabolic landscape. The levels of 87 percent of the molecules detected had been shifted up or down by factors ranging from 2-fold to 10,000-fold. 
The most profoundly altered pathways involved steroid hormones, eicosanoid hormones, sugar, fatty acid, and bile acid. "These hormones have very important functions in our health," says Antunes. "They [hormones observed here] control our immune system, reproductive functions, mineral balance, sugar metabolism, and many other important aspects of human metabolism."
OK, I don't know about you, but the thought of antibiotics profoundly altering various hormone levels in my body is a bit frightening. The quotation above really got my attention with regards to my interest from a gluten-intolerance / Celiac Disease standpoint, particularly  the words "control our immune system".  Given that Coeliac disease is an autoimmune disorder of the small intestine, and that the researchers observed huge shifts in the metabolic landscape that included hormones that control our immune system, one really has to start wondering if there IS a connection between Antibiotic use and Celiac Disease.

This is where I also made a mental jump back to the associated (hypothesized) "leaky-gut syndrome" and the proposed step where leaky-gut leads to the stimulated release of cytokines. Well, Cytokines are cell-signaling protein molecules secreted by the nervous and immune systems. And, more interesting may be the fact that (as Wikipedia notes): "Biochemists disagree as to which molecules should be termed cytokines and which hormones. As we learn more about each, anatomic and structural distinctions between the two are fading."    So, if cytokines are essentially a class of hormone, and antibiotics have been shown to substantially alter hormone balances, could this "leaky gut" view of Celiac Disease, Autism, and such have some merit? Hmmm... sure seems there could be some connection.

Antibiotics Can Lead to Bad Things (for Human Health)

If you have read this Gluten-Free Blog entry to this point, you are probably already thinking: "antibiotics may be causing issues for people". Well, I was sure thinking that as I read the study that inspired me to write this, and there is a nice summary-statement included in that scientific article that will confirm this line of thinking:
The findings have two important implications, says Antunes. "First, our work shows that the unnecessary use of antibiotics has deleterious effects on human health that were previously unappreciated. Also, the fact that our gut microbes control these important molecules raises the possibility that manipulating these microbes could be used to modulate diseases that have hormonal or metabolic origins (such as inmmunodeficiency, depression, diabetes and others).
The bottom-line (as I took it to be): avoid unnecessary exposure to antibiotics. Simply put, there are risks with taking them. Sure, there are some types of infections that may absolutely require treatment with antibiotics, but all too often they are over-prescribed because we (the end-user) go in to see our doctor and make a big fuss about "needing" antibiotics, or perhaps we encounter a doctor whose first line of "treatment" is antibiotics for everything (been there before!). Fact is, we need to be educated (medical) consumers and understand what antibiotics can do for us and what they can not.

Although this is just my opinion, I personally think there IS a connection between antibiotic use and Celiac Disease / Gluten-Intolerance. I developed this condition soon after being given a course of antibiotics for a supposed sinus infection (one which a week later another doctor decided I never had!), and it just makes me that much more curious as to whether there is a connection. Also, I know a LOT of people that also "developed" Celiac Disease and are now on a mandatory gluten-free diet for life, soon after a round or two of antibiotics (especially in people that normally did not take antibiotics). This is perhaps purely anecdotal evidence, but I have encountered enough such "evidence" to make me wonder. And, this scientific study just helped provide a foundation for at least a portion of my concerns.

Peruse this Gluten-Free Blog for all sorts of gluten-free recipes, product-reviews, and related information.

21 comments:

Anonymous said...

I was prescribed antibiotics every time I visited the dentist as a precaution (it was recommended following a heart operation but it's no longer considered ncessary), and less than three years ago I was diagnosed with coeliac disease. Reading this blog, I wonder if I have been unlucky, with the combination of a genetic predisposition to CD coupled with having antibiotics every four months during my childhood?

Dave Bel said...

Thanks for sharing. This blog is very helpful for me! Thanks again.

? said...

My son who is now 12 was diagnosed with Allergic Colitis a year ago right after he was prescribed a very strong dose of antibiotics for a staph infection that got out of control. He is now on a GF diet for life. I too agree that there is connection between antibiotics and gastro problems.

Brittany said...

I am so glad to find this post! I was just diagnosed with a gluten allergy after a 5-month round of antibiotics and now, at 22, seem to be gluten-free for life. I suspected there was a correlation, but this article convinces me more than my suspicions aren't just crazy...

Kristina said...

Great post. I'm a Canadian writer who has heard evidence of this connection and I'm looking to chat with someone whose child has been diagnosed with an inflammatory bowel disease after taking antibiotics. If you know anyone, please encourage them to email me at: bykriscampbell at gmail dot com.

Bach said...

I was on a 9-month of strong antibiotic treatment for a serious lung infection last year, and now I cannot eat any wheat (gluten) contained food which I normally did before the treatment. If I eat it, I'll have very bad diarrhea frequently. But it gets better right after I stop eating any gluten food. I've been searching around on the internet and found out my symptom is very similar to Celiac Disease. This post convinces me that there's something wrong with my digestive system, and I'll definitely go to see the doctor for diagnosis of Celiac Disease.

Jo said...

My son was diagnosed with coeliac disease in August last year. He had two bouts of atypical pneumonia, treated with heavy antibiotics one when he was 6, then again at 7 a 1/2. His symptoms started after the first pneumonia. I think there is a link between coeliac and antibiotic use. Its always great to hear of others who think so, as the medical profession is not particularly well educated on this disease, and I've often found them dismissive.
I just read this article which I think also suggests a link

http://www.scientificamerican.com/article.cfm?id=celiac-disease-insights&page=1

Jo

Anonymous said...

In 2005 I began having ear infections. For three years the doctors kept saying we are going to get it this time, and giving me more. I began having a fluttering feeling in my colon area during the antibiotic use. Now 6 years later I have so many problems. Muscle spasms/twitches, eczema, bone/joint paint, at 40 I was in Orthodontics, great hair loss. I could go on and on. I never had any digestive symptoms before this. I began to remove Gluten and the raw feeling and inflamed feeling inmy colon area is much less. However, I suspect there is great damage. I have been to SO many doctors. All they want to do is give me Antidepressants. They never once in six years looked at anything but lab work.

Jody Ruttan said...

I developed severe gluten intolerance immediately after a seven day round of antibiotics before dental surgery. I also developed severe lactose intolerance after several rounds of strong antibiotics for an infection in my late teens. Although I have no solid proof the antibiotics caused the intolerances, the coincidence is a little too much.

Anonymous said...

About 15 years ago, I was diagnosed as having coeliac disease and acid reflux after, coincidently, a short history of taking several courses of antibiotics and some anti-parasitics to fight off a stomach bug, which I had picked up from travelling through India and Nepal. Also, I found I had become sensitive to caffeine, sugar and fatty foods like dairy. More worryingly, I have recently discovered that my stomach now reacts very badly to antibiotics, making it impossible for me to complete a course. Yet, in spite of my history I am amazed-frustrated how often doctors are still so keen to prescribe these drugs especially when they are not essential!

Anonymous said...

About a year ago I had my wisdom teeth taken out and was given about a week or 2 worth of antibiotics to take. I have since developed a lactose and gluten intolerance. I grew up eating bread and milk daily and have never had an allergy in my life. I am starting to wonder if there is a connection here too.

Anonymous said...

I have to agree with this article. I am on antibiotics for a minimum of 18 months due to Q Fever and Lyme. I have felt pretty horrible throughout my treatment, only month 4 right now. A few weeks ago I decided to try a natural food detox. It cuts gluten, sugar, caffeine, alcohol, soy, and dairy. After four days I had so much energy and my insomnia was gone. I'm having a really hard time sticking to this diet though and am paying the price.

Anonymous said...

My son was on low-dose antibiotics for a year for his acne. He had really never been sick in his life. Suddenly he had a host of problems, including asthma, sinusitis, chest pain, trouble swallowing, constant acid reflux and persistent cough. He started to experience panic attacks when he felt that he couldn't breathe with the lump in his throat. He was diagnosed with eosinophilic esophagitis. We tried the drug approach, but in the end he has had much better success with a gluten-free diet. I have since seen studies which show that this problem is common is young men taking antibiotics for acne. Especially bad when not taken with water...seems to me that not only the gut but the entire digestive tract is compromised.

Sarah said...

I wonder if antibiotics caused my gluten intolerance as well. I suspect I have leaky gut because I have multiple intolerances, not just to gluten. I realized almost a year ago that I react to flaxseed. Over three months ago I discovered the gluten intolerance by pulling up a site that said any remaining acne you may have could be caused by it. I'd been trying everything I could think of to clear my skin and thought what the heck; I'd give it a try. After I began cutting out dairy, I started mixing a dairy, soy, and gluten free meal replacement powder with coconut milk and developed an intolerance to coconut. Right now I believe the powder mixed with just water is fine but doesn't taste as good. I'm hoping I can still handle nuts in small servings and not everyday. I started eating gluten-free fruit and nut bars after I cut the protein powder and coconut milk mixture and think they may have been causing gut issues as well. When I was in college, I went to the dermatologist for really bad acne. I can't remember when I started on antibiotics, but I was on them for several years, mainly Bactrim DS. I never noticed any symptoms while using it, so I thought I was fine on it. My dermatologist would check my folic acid levels and never noticed a problem there. I knew, however, that the antibiotics were not getting to the root cause of my acne, so I eventually stopped using them. While I did all kinds of things to clear my skin, like changing towels and pillowcases frequently, washing my face twice a day instead of once, eating more organic foods and cutting foods that could affect hormones, adding supplements to balance hormones, like omega supplements, and doing other things, I could never get it to clear. That's what led me to try cutting gluten, and so far, cutting that and other food intolerances has had the most dramatic effect on my skin, not to mention other problems like constipation that I'd been experiencing for years. I also have hypothyroidism, and I wonder if the antibiotic use and gluten intolerance caused that as well. I've noticed low-thyroid symptoms, like low body temperature, improving as well with the elimination of gluten. I wonder about reintroducing other foods to which I'm currently intolerant back into my diet at some point, after my gut has healed, but I wonder if I should stay away from gluten and flaxseed for life because of the severity of their reactions (thyroid problems with gluten, eosinophilia with flaxseed). I wonder how things would be now if I never went to the dermatologist. My dad's and sister's acne eventually went away as they got older. I wonder if mine would have as well.

Anonymous said...

We've questioned whether or not my son has ASD, and recently bought Dr. Sears' book on Autism. Of all the possible contributors to ASD, over-use of antibiotics is the one that makes sense in our "story". My son had antibiotic-happy physicians as an infant-toddler, and grew to have violent intestinal reactions to them - finally we found out he is now allergic to Penicillin. We have not had him tested, but we are going gluten-free because I am convinced of the connection and hope to see improvement...

Amanda Yoder said...

I have had to use antibiotics multiple times per year for the past 5 years for sinus infections (and even when I wait it out for weeks to try to get it to go away on its own, I end up needing the antibiotic), and I recently developed celiac. I definitely thought that the antibiotic frequency caused what I thought was leaky gut, later to find out it's celiac (and the partner tomato-sensitivity and lactose issues) :-(. I think this has a lot of merit, but when antibiotics are necessary how can we avoid it??

Anonymous said...

Can someone please answer my questions regarding celiac/antibiotic use/genetic testing? My Gastro had a very strong suspicion of celiac disease for me; but after getting a negative result on the genetic marker blood test, totally ruled out celiac. IF I have celiac disease that was caused by antibiotic use, is it possible or even probable that this genetic marker celiac test would be negative? That is, is it likely that I do indeed have celiac even though this blood test was negative? I was treated for seven months for chronic lyme disease with very heavy doses, including IV doses, of several very strong antibiotics in 2012 and I have been very sick with multiple symptoms. Also, I have been gluten free for about 3 months now and some of my symptoms are gone or improved. Thank you.

Mike Eberhart said...

Anonymous,
I cannot claim to be qualified to answer your question with any scientific certainty, but I can offer my opinion. Given the (antibiotic use) history you have described, it seems possible that your body, somewhere along the way, may have produced some antibodies against gluten proteins, because of this long-term exposure to antibiotics.

I base my opinion on the science article I referenced in this blog, as well as other scientific publications I have read. Furthermore, I have heard from a lot of people how, rather coincidentally, they "developed" celiac (of Celiac Disease like symptoms) after taking one or multiple courses of antibiotics. In a day and age where antibiotics are so incredibly overprescribed (and/or incorrectly prescribed for things like viruses -- which antibiotics will not work on -- rather than bacterial infections which they can treat), there are certainly no shortage of people that have had antibiotics around the time they are diagnosed with CD. But, that does not necessarily imply causality. So, I personally hope that over the longer term the science community studies any possible links between food-allergies and antibiotic use in more detail so we can all make informed decisions.

Best wishes with getting through your situation, and glad to here things are improving for you since avoiding gluten.

imhbillingservices said...

I too seem to have developed a gluten sensitivity after two consecutive rounds of antibiotics. Very frustrating, and life changing. I am still trying to get well after getting sick from these drugs. So weak, and so tired. Too bad...I really liked breads and the likes of bread. :-(

Anonymous said...

I was on prophylactic doxycycline for almost 6 weeks.I started having severe digestive issues,biopsy for celiac was negative.I have been in the ER 7 times in the last five months.I finally saw an osteopath who told me my intestinal villi were damaged by the antibiotic.I have multiple vitamin and mineral deficiencies.I stopped gluten and started to feel better in 24 hours.I have a long way to go after all this time.

Anonymous said...

I took tons of antibiotics in childhood... because of chronic respiratory illnesses and crises that never stopped. Good job... My life (and myself) changed when I understood that I needed a gluten and diary free diet (I was 22, it took many years). Now I know that it can be linked to those antibiotics taken though early years. I think that, maybe, if the diary intolerance had been diagnosed when I was a child - I'm 90% sure that's what caused respiratory crises - I wouldn't be in that situation currently and I wouldn't have suffer that much all those years.